A Novel Endoscopic Approach to Fibroadipose Vascular Anomaly

Open surgery is the standard treatment for fibroadipose vascular anomalies (FAVA). This study evaluated an endoscopic approach for FAVA, assessing its safety and feasibility.

Data from October 1, 2019, and May 1, 2024, were analyzed from the Vascular Anomalies Center database at our institution. Patients with FAVA Stage I (pain stage) or II (contracture stage) were included and divided into the endoscopic surgery group (ESG) and open surgery group (OSG).

In total, 101 patients underwent 110 procedures. In ESG, 42 patients (16 males and 26 females; 31 with Stage I and 11 with Stage II) underwent radical excision (with tendon lengthening in 2 patients). Ten patients underwent an open surgery. In OSG, 63 patients (18 males and 45 females; 30 with Stage I and 33 with Stage II) underwent radical excision (with tendon lengthening in 12 patients). The OSG had significantly shorter operative time than the ESG (p = 0.009). Furthermore, The OSG had longer hospitalization time (p = 0.022) than the ESG. The blood loss in the OSG was greater than that in the ESG, but without statistical difference (p = 0.069). During follow-up, the incidence of wound complications (p = 0.121) and residual symptoms (p = 0.179) were slightly higher in the OSG.

Endoscopic surgery is a safe and effective treatment for FAVA, promoting faster habilitation and improved patient satisfaction. This method may also serve as a reference for the excision of other benign muscle and soft tissue masses.